Peripheral Blood Lymphocyte Subpopulations in Patients Following Small Diameter Metal-On-Metal Total Hip Replacement at Long-Term Follow-Up.

(1) Background: The objective of the present study was to investigate peripheral blood lymphocyte subpopulations in patients with small diameter metal-on-metal total hip arthroplasty (MoM THA) and elevated blood metal ion concentrations at long-term follow-up. The hypothesis was that increased blood metal ion levels or the presence of adverse local tissue reactions (ALTR) would be associated with changes in the peripheral expression of lymphocyte subpopulations, which could potentially serve as early diagnostic markers for metal wear related complications. (2) Methods: Peripheral blood samples were analyzed for leucocyte subgroups (CD3, CD4, CD8, CD14, CD16/CD56, CD25/CD127, CD19, IFN-γ, IL-4 and IL-17A cells) in 34 patients with elevated blood metal ion levels (combined cobalt and chromium levels >2 µg/L) following small head MoM THA at a mean follow-up of 15.

T Helper Cell Infiltration in Osteoarthritis-Related Knee Pain and Disability.

Despite the growing body of literature demonstrating a crucial role of T helper cell (Th) responses in the pathogenesis of osteoarthritis (OA), only few clinical studies have assessed interactions between Th cells and OA-related symptoms. Yet, the inclusion of clinical data in the interpretation of cellular analyses of Th cell infiltration is essential to reveal the mechanisms underlying the complex pathophysiology of OA pain and disability. Thus, the aim of the study was to analyze the infiltration pattern of Th cells in systemic (peripheral blood) and joint-derived (synovial membrane and fluid) samples from patients with knee OA in relation to OA-induced pain and disability.

Prospective Long-term Follow-up of Autologous Chondrocyte Implantation With Periosteum Versus Matrix-Associated Autologous Chondrocyte Implantation: A Randomized Clinical Trial.

Background: Matrix-associated autologous chondrocyte implantation (MACI) is a further development of the original autologous chondrocyte implantation periosteal flap technique (ACI-P) for the treatment of articular cartilage defects.

Purpose: We aimed to establish whether MACI or ACI-P provides superior long-term outcomes in terms of patient satisfaction, clinical assessment, and magnetic resonance imaging (MRI) evaluation.

Study Design: Randomized controlled trial; Level of evidence, 2.

Blood Metal Ion Release After Primary Total Knee Arthroplasty: A Prospective Study.

Objectives: To investigate the course of in vivo blood metal ion levels in patients undergoing primary total knee arthroplasty (TKA) and to investigate potential risk factors associated with metal ion release in these patients.

Methods: Twenty-five patients with indication for TKA were included in this prospective study. Whole blood metal ion analysis was performed pre-operatively and at 1 week, 6 weeks, 3 months, 6 months, and 12 months postoperatively.

Synovial Cytokines Significantly Correlate with Osteoarthritis-Related Knee Pain and Disability: Inflammatory Mediators of Potential Clinical Relevance.

The aim of this study was to identify inflammatory mediators of potential clinical relevance in synovial fluid (SF) samples of patients with knee osteoarthritis (OA). Therefore, radiographic OA severity, knee pain and function of 34 OA patients undergoing unicompartmental (UC) and bicompartmental (BC) knee arthroplasty were assessed prior to surgery and SF samples were analyzed for a broad variety of inflammatory mediators, including interleukins (ILs), interferons (IFNs), C-X-C motif ligand chemokines (CXCLs), and growth factors (nerve growth factor; NGF, vascular endothelial growth factor; VEGF, and stem cell growth factor β; SCGF-β) using multiplex assay. Significant differences were observed between the SF levels of different inflammatory markers.

Posterior-only surgery with preoperative skeletal traction for management of severe scoliosis.

Purpose: The surgical treatment of severe adolescent spinal deformities is challenging and carries substantial risks of mortality and morbidity. To mitigate this risk, surgeons have employed various methods as this study designed to evaluate the safety and effectiveness of preoperative halo-femoral or halo gravity traction (HGT) followed by posterior-only surgery in the management of severe scoliosis.

Method: A total number of 23 patients with severe scoliosis treated by preoperative skeletal traction (halo gravity or halo femoral) followed by posterior fusion and instrumentation in one stage.

Management of Retinal Vein Occlusion, Who Is Responsible?

Retinal vein occlusion (RVO) is a common retinal vascular occlusive disorder and is associated with a variety of systemic risk factors. The aim of this study was to investigate whether the underlying diseases were evaluated and managed appropriately by ophthalmologists. We performed a study of 1344 patients with retinal vein occlusion (RVO).

Treatment of nonunion of the forearm bones with posterior interosseous bone flap.

Background: Reconstructions of forearm fracture nonunions are frequently complex. A few studies that help guide the treatment of forearm nonunion have been reported. We offer a novel surgical technique to treat nonunion of the forearm using a regional vascularized bone graft.

A supplemental video teaching tool enhances splinting skills.

Background: The ability to apply casts and splints is a technical skill that requires practice and understanding of basic principles of musculoskeletal medicine. A video in which a given procedure is simulated on a dummy can represent reality under controlled conditions. A decrease in physician competency in musculoskeletal medicine is the result of educational deficiencies at the medical school level.

Biological plate osteosynthesis of comminuted subtrochanteric fractures: a clinical study.

Background: Comminuted subtrochantric fractures represent a challenge for trauma surgeons. Achieving appropriate reduction and stable fixation can be difficult, some techniques being associated with technical difficulties and complications. The aim of this study is the assessment of biologic fixation in comminuted subtrochantric fractures.

Effectiveness of educational intervention on undermanagement of osteoporosis in fragility fractures.

Purpose: Fragility fractures are characterized by a low energy trauma and should be considered as potentially osteoporosis-related fractures. This study aimed to determine whether the orthopedic surgeons' awareness could increase the osteoporosis management rate in patients with fragility fractures.

Method: This study was undertaken in three phases: evaluation of existing practice patterns, educational intervention and evaluation of the effect of the training.

Are hospitalized patients with fragile fractures managed properly in relation to underlying osteoporosis?

Background: Osteoporotic fractures are an important reason of morbidity and mortality in the elderly population and impose huge economic burden on health services. There have been major advances in the treatment of osteoporosis, and many steps can be taken to prevent or even reduce the risk of fractures. Orthopedic surgeons manage most of these fractures and are often the only clinician seen by the patient.

Entire posterior process talus fracture: a report of two cases.

The complex anatomy of the posterior process of the talus includes the medial and lateral tubercles extending from the talar body. Review of the current literature indicates that fracture of the entire posterior process of the talus is a rare injury. Two patients presented to our emergency department after motor vehicle accidents, and both were diagnosed with entire posterior process talus fractures.

Knowledge of orthopaedic surgeons in managing patients with fragility fracture.

Purpose: Fragility fractures represent a major health problem, as they cause deformity, disability and increased mortality rates. Orthopaedic surgeons should identify patients with fragility fractures and manage their osteoporosis in order to reduce the risk of future fracture; therefore, orthopaedic surgeons' knowledge about managing fragile fracture should be evaluated.

Methods: A questionnaire was administered to 2,910 orthopaedic surgeons to address the respondents' knowledge.

Pin and plate fixation in complex distal humerus fractures: surgical technique and results.

Purpose: Complex distal humerus fractures are difficult to fix by conventional methods, especially in comminuted low distal humerus fractures. We propose a technique using small diameter K-wires and a plate on the humeral shaft.

Methods: Between May 2007 and March 2009, 19 patients with poor bone quality showing comminuted or low distal humerus fractures involving the articular surface were referred to our institution and were primarily treated by this technique that we called "pin and plate fixation".

Treatment of Kienböck disease by lunate core decompression.

Purpose: Kienböck disease is characterized by avascular necrosis of the lunate bone, which is usually progressive without treatment. This study examined lunate core decompression for its treatment potential.

Methods: We surgically treated 20 patients with stage 1 to 3b Kienböck disease with lunate core decompression.